A tale of two hospitals
It must have been a bit disconcerting for the citizens of Basildon to discover this past fortnight that their hospital has the dubious distinction of coming bottom of two separate league tables. The government watchdog, the Care Quality Commission, identified among the hospital’s several failings “a lack of basic nursing skills, ward curtains spattered with blood, mould on vital equipment and patients being left in casualty for up to 10 hours”. Meanwhile, the privately funded health information service, Dr Foster, also gave it the lowest patient safety rating of 148 hospitals, based on 13 criteria including death rates, surgical errors and infection control measures. What to make of this? Why should the Basildon experience be so different from, for example, Basingstoke, whose demographic characteristics as a new town, built to accommodate the London overspill in the Fifties, is very similar. But Basingstoke is a true centre of excellence, whose surgeons are widely recognised as major pioneers in cancer surgery. Over the past 10 years I have had the opportunity to reflect on this question, having visited and lectured at more than 40 hospitals, and discovered how readily one can distinguish the good from the less good. This has nothing to do with the usual excuses of lack of funding, antiquated facilities or “poor management”. Rather, the crucial factor is the collegiality of the medical staff. In the “good” they almost all attend the lunchtime academic meetings and there is much vigorous discussion. In the “less good” they can’t be bothered. It might seem a small matter, but it is easy to see why this could make all the difference.
THINGS THAT GO BUMP
Further to the comments last week from those who act out their vivid dreams to the discomfort of their partners, a reader from Milton Keynes describes how her 65-year-old husband has, while sharing the marital bed, “hurt and bruised me, which came to a head when I ended up on the floor”. He is, at the time, unaware of his actions but on being woken recounts dreams in which he is either being chased by wild animals or playing badminton. These nocturnal disturbances should not be confused with the sudden body jerks or “periodic leg movements”, where partners find themselves on the receiving end of a kick. These may, if very troublesome, warrant treatment with a small dose of the tranquilliser clonazepam.